BACKGROUND: Carcinoma of the gallbladder (CaGB) is common in India and its prognosis depends primarily on the extent of the disease and histological type. We aim to study the role of guided fine needle aspiration cytology (FNAC) for diagnosis of CaGB and to evaluate the feasibility of applying world health organization (WHO) classification on fine needle aspiration (FNA) material to predict the outcome of the tumor. MATERIALS AND METHODS: Retrospective cytomorphologic analysis was performed in all cases of CaGB diagnosed by ultrasound (US) guided FNAC over a period of 2 years. A specific subtype was assigned according to WHO classification based on characteristic cytologic features. These included papillary or acinar arrangement, intra and extracellular mucin, keratin, rosettes and columnar, signet ring, atypical squamous, small, clear, spindle and giant cells. Correlation with histopathology was performed when available. RESULTS: A total of 541 aspirations with clinical or radiological suspicion of primary CaGB were studied. Of these, 54 aspirates were unsatisfactory. Fifty cases were negative for malignancy. Remaining 437 aspirates were positive for carcinoma. Histopathologic diagnosis was available in 32 cases. Adenocarcinoma was the most frequent diagnosis in 86.7% of cases. Mucinous, signet ring, adenosquamous, squamous, small cell, mixed adenoneuroendocrine and undifferentiated carcinoma including spindle and giant cell subtypes were diagnosed identifying specific features on FNAC. Correlation with histopathology was present in all, but one case giving rise to sensitivity of 96.8%. No post-FNA complications were recorded. CONCLUSIONS: US guided FNAC is a safe and effective method to diagnose CaGB. Although, rare, clinically and prognostically significant variants described in WHO classification can be detected on cytology.
BACKGROUND:Carcinoma of the gallbladder (CaGB) is common in India and its prognosis depends primarily on the extent of the disease and histological type. We aim to study the role of guided fine needle aspiration cytology (FNAC) for diagnosis of CaGB and to evaluate the feasibility of applying world health organization (WHO) classification on fine needle aspiration (FNA) material to predict the outcome of the tumor. MATERIALS AND METHODS: Retrospective cytomorphologic analysis was performed in all cases of CaGB diagnosed by ultrasound (US) guided FNAC over a period of 2 years. A specific subtype was assigned according to WHO classification based on characteristiccytologic features. These included papillary or acinar arrangement, intra and extracellular mucin, keratin, rosettes and columnar, signet ring, atypical squamous, small, clear, spindle and giant cells. Correlation with histopathology was performed when available. RESULTS: A total of 541 aspirations with clinical or radiological suspicion of primary CaGB were studied. Of these, 54 aspirates were unsatisfactory. Fifty cases were negative for malignancy. Remaining 437 aspirates were positive for carcinoma. Histopathologic diagnosis was available in 32 cases. Adenocarcinoma was the most frequent diagnosis in 86.7% of cases. Mucinous, signet ring, adenosquamous, squamous, small cell, mixed adenoneuroendocrine and undifferentiated carcinoma including spindle and giant cell subtypes were diagnosed identifying specific features on FNAC. Correlation with histopathology was present in all, but one case giving rise to sensitivity of 96.8%. No post-FNA complications were recorded. CONCLUSIONS: US guided FNAC is a safe and effective method to diagnose CaGB. Although, rare, clinically and prognostically significant variants described in WHO classification can be detected on cytology.
Entities:
Keywords:
Cytomorphology; fine needle aspiration cytology; gallbladder carcinoma; ultrasound; world health organization classification
Authors: Juan C Roa; Oscar Tapia; Asli Cakir; Olca Basturk; Nevra Dursun; Deniz Akdemir; Burcu Saka; Hector Losada; Pelin Bagci; N Volkan Adsay Journal: Mod Pathol Date: 2011-04-29 Impact factor: 7.842
Authors: V K Shukla; M Pandey; M Kumar; B P Sood; A Gupta; N C Aryya; R C Shukla; D N Verma Journal: Acta Cytol Date: 1997 Nov-Dec Impact factor: 2.319
Authors: William G Hawkins; Ronald P DeMatteo; William R Jarnagin; Leah Ben-Porat; Leslie H Blumgart; Yuman Fong Journal: Ann Surg Oncol Date: 2004-03 Impact factor: 5.344
Authors: Reed I Ayabe; Michael Wach; Samantha Ruff; Sean Martin; Laurence Diggs; Timothy Wiemken; Leslie Hinyard; Jeremy L Davis; Carrie Luu; Jonathan M Hernandez Journal: Ann Surg Oncol Date: 2019-05-17 Impact factor: 5.344
Authors: Yael Berger; Brianne J Sullivan; Natasha L Leigh; Eliahu Y Bekhor; Pooja Dhorajiya; Malary Mani; Deepa R Magge; Da Eun Cha; Umut Sarpel; Spiros P Hiotis; Daniel M Labow; Stephen C Ward; Benjamin J Golas; Noah A Cohen Journal: Ann Surg Oncol Date: 2022-04-18 Impact factor: 5.344